A patient with panhypopituitarism and visual field defects due to a Rathke's cleft cyst is presented. These cysts are commonly found in random pituitaries examined at necropsy, but rarely produce symptoms. Subtle endocrine deficiencies, however, may now be uncovered more frequently with modern diagnostic techniques. An unusual and unreported feature of this cyst was an apudamyloid stroma. This would imply that cells derived from the neural crest participate in the formation of the cyst. Recognition of these cysts at the time of operation is important in avoiding confusion with pituitary adenomas and unnecessarily aggressive treatment.
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http://dx.doi.org/10.1136/jnnp.38.8.782 | DOI Listing |
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.
Background: The co-occurrence of Rathke cleft cysts (RCCs) and meningiomas in the sellar and parasellar regions represents an exceedingly rare clinical entity. Achieving maximal resection through a single operative approach while minimizing adverse events is challenging, often necessitating multiple surgical approaches, as suggested by previous reports.
Observations: The authors report the case of a 49-year-old female with a history of kidney transplant who presented with headaches and was diagnosed with coexisting RCC and meningioma in the sellar and planum sphenoidale regions, respectively.
J Neurosurg Case Lessons
January 2025
Department of Neurological Surgery, University of California, San Diego, La Jolla, California.
Background: Rathke cleft cysts (RCCs) are benign sellar/suprasellar lesions that result from mucin-secreting vestigial remnants within the pars intermedia of the pituitary gland. When symptomatic, they can present with retro-orbital headaches, visual field defects, and/or pituitary dysfunction.
Observations: A 35-year-old female presented with subacute retro-orbital headache, right ptosis, and blurred vision.
BMJ Case Rep
January 2025
Radiology, The Aga Khan University, Karachi, Sindh, Pakistan
Cureus
December 2024
Department of Technology and Clinical Trials, Advanced Research, Deerfield Beach, USA.
This paper investigates the potential of artificial intelligence (AI) and machine learning (ML) to enhance the differentiation of cystic lesions in the sellar region, such as pituitary adenomas, Rathke cleft cysts (RCCs) and craniopharyngiomas (CP), through the use of advanced neuroimaging techniques, particularly magnetic resonance imaging (MRI). The goal is to explore how AI-driven models, including convolutional neural networks (CNNs), deep learning, and ensemble methods, can overcome the limitations of traditional diagnostic approaches, providing more accurate and early differentiation of these lesions. The review incorporates findings from critical studies, such as using the Open Access Series of Imaging Studies (OASIS) dataset (Kaggle, San Francisco, USA) for MRI-based brain research, highlighting the significance of statistical rigor and automated segmentation in developing reliable AI models.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Neurosurgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Background: Craniopharyngiomas are epithelial tumors derived from the remnants of the Rathke pouch, while Rathke cleft cysts (RCC) are benign cystic lesions originating from the Rathke pouch itself [1]. Rathke cleft cysts comprise 10-15% of the hypophyseal tumors, while craniopharyngiomas are relatively rare, comprising only 2-5% of intracranial tumors [2]. Both located in the sellar and parasellar regions and share clinical symptoms including headache, visual disturbances, and endocrine dysfunction [3].
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